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Down load the application form from the NDSS to join the free service from here:I am in Australia and not part of the NDSS, so I am paying $50 for 100 test strips. Yeah it's tough. And unfair.
I don't think I'm pretending anything. I've not had my test strips on prescription for so long that I've got used to the idea. Not so easy for a type I.
What exactly is the situation for type I diabetics in the United Kingdom? Are there changes afoot? What are the facts? I'm confused now!
According to my CCG, and also Bolton CCG, they are expecting NICE to update their guidelines soon. There is a NICE CG committee set up to discuss the GMMMB study imminent. Apart from the Vanguard CCG's most others are hanging fire until NICE makes a move.Well until NICE change their guidance for type ones to test infrequently, it's not up to the government to "pull funding" for test strips. CCGs might try, but we still have the NICE guidance to fall back on.
What's the GMMMB study? I can't find any references to it.According to my CCG, and also Bolton CCG, they are expecting NICE to update their guidelines soon. There is a NICE CG committee set up to discuss the GMMMB study imminent. Apart from the Vanguard CCG's most others are hanging fire until NICE makes a move.
It is (so far) a matter for each local CCG to decide how they interpret the GMMMB study data. Some appear to cut their overall budget in a way so that only T2D will be affected, some like mine appear to be applying it to all D: patients in their care. Also some CCG's offer meters that are not on the GMMMB Approved list
So it is becoming a Postcode lottery. The cake is being reduced, but portion size is variable. It is not a Government initiative, purely an NHS internal matter.
Aww that's a shame... the Gluco RX meter I was given was terrible. I find the accu-chek mobile is really good with having the 6 lancets in a drum and the test strips as a cassette it's so much easier when out & about. Wonder where my "obsolete meter" came on the list, that was also a really good meter can't for the life of me remember the name of it... was a little chunky white one sure I got it free off a link I clicked.Ooopsie. It seems that the Gluco RX made the final selection squeaking in with 1 penny to spare, but none of the Accuchek or Abbott meters made the grade.
The meters could well be free on the back of on-going test strip sales...not an unusual marketing move.I wonder if she gets a letter like mine? MP perk? Anyhow, in uk it is NHS not Gov that is driving this initiative, so this is a deviation from the OP. My CCG is one of the new Vanguard ones, so is piloting this change. It estimates it will save £1m a year (increasing as target population increases, like my girth), and they, combined with the other Vanguard CCG, will be saving over £4m per annum for the NHS. I note that the list of bgl meters that can be approved by a CCG under the selection rules is around 20, and does not include many of the well known brands. So we may see some major players struggling to make a profit.
They could, of course, reduce the price of strips to less than the cutoff value, but then they have to go back through the selection process again. Could benefit us in the long run.
Think a typo is indicated. It used to be GMMMGWhat's the GMMMB study? I can't find any references to it.
As I've said previously, it would be a real surprise for NICE to update the Type 1 guideline to reduce the amount of testing required, given that the guideline is completely evidence based and all the evidence shown shows that more testing has better outcomes for T1.
I'm not sure on the T2 stuff. Given the last update was December 2015, they may make a small update, but given that NICE advice for the majority of T2s is not to offer SMBG, it hardly seems like there's a significant change there?
Agree on both points.Strangely the SD Codefree was the cheapest for strips, but it was eliminated from the contest by the CCG study group, and is not an approved meter. There were some issues with it that meant it did not meet the other selection criteria.
Personally I do not find the SD that reliable or accurate, and it has often told me my hypo is NOT Happening coz the bgl reading is above 6 mmol.l, even though my NEO may be saying 3,8 I cannot rely on my SD but use it to keep an eye on my NEO that sometimes also misreads (but rarely) I normally get the SD reading 1,5 to 2 mmol/l higher than the NEO, so if it is not, then I may need to retest.
Back to topic. I think if T.M. intervened then it would look like a stitch up and self interest.
Accuchek decided not to take part in the study, so were totally excluded. None of their meters made the initial list. I suspect they also fell at the cost/strip hurdle.Aww that's a shame... the Gluco RX meter I was given was terrible. I find the accu-chek mobile is really good with having the 6 lancets in a drum and the test strips as a cassette it's so much easier when out & about. Wonder where my "obsolete meter" came on the list, that was also a really good meter can't for the life of me remember the name of it... was a little chunky white one sure I got it free off a link I clicked.
Some patients will require SMBG devices chosen by their specialist care team. Where an alternative meter is chosen, the healthcare professional should specify the reason of their preferred choice to reduce the risk of subsequent change in primary care.
Two nights ago I had a hypo, and the luxury of 3 meters. But the SD and the new meter both gave readings above 5 mmol/l, and so majority rule would dictate my hypo did not exist. Can't win! Who tests the tester?Agree on both points.
My SD Codefree reads higher than my Contour Next. Odd thing is, when I convert my last HbA1c and compare with previous month's average mmol/l it seems the SD readings tally more. I know such conversions aren't great and Contour readings reflect my feelings better but odd, nonetheless. Suppose the next move is to get a third meter and see which that agrees with?
The test strips on NHS is a CCG issue, no doubt under guidance from NHS England. Probably not appropriate for Mrs May to intervene?
Of course, value of meters is in trying to identify what caused the hypo rather than how low you went.Two nights ago I has a hypo, and the luxury of 3 meters. But the SD and the new meter both gave readings above 5 mmol/l, and so majority rule would dictate my hypo did not exist. Can't win! Who tests the tester?
I was aware of the contents of this report, and others like it, but I refrained from posting it here since it contains commercially sensitive information which should not be published on a public forum. This may be a breach of confidentiality agreements.Thanks for that @Oldvatr . I hadn't realised that it was a Greater Manchester group looking at it. What I note is that in their guidance, they state:
So, for example, if you are a T1 using a meter that has a bolus calculator, whilst a justification would be needed, it's unlikely that they'd change it away. I suspect that one of the reasons the CodeFree didn't pass is that they don't give the meter away for free....
I think there's perhaps less need to worry with regard to the UK than is being made out.
If this particular report is confidential it should not be publicly available on the web. The data shown on the page is the NHS Drugs Tariff price for the test strips, and the evaluation criteria don't reveal any further details.I was aware of the contents of this report, and others like it, but I refrained from posting it here since it contains commercially sensitive information which should not be published on a public forum. This may be a breach of confidentiality agreements.
Yes I will have to apply a correction of -12% to each reading, but I note that the guidance ranges given out on this site and others like DVLA seem to still be the whole blood values. But no one has confirmed this either way, so we are currently totally in the mire if we are hypo unawareOf course, value of meters is in trying to identify what caused the hypo rather than how low you went.
Whilst I try (like everyone here) to maintain mid-range b/g levels, I also try to identify which foods (and activities) cause biggest variations between before & after readings. If the differences are consistent between meters maybe we can reset our own tolerance levels e.g. know that 5 or below is dangerous instead of, say, 4mmol/l.
Just a thought.
Since it is likely that there may be legal fights for compensation by some of the excluded manufacturers, I would still be careful about broadcasting this info.If this particular report is confidential it should not be publicly available on the web. The data shown on the page is the NHS Drugs Tariff price for the test strips, and the evaluation criteria don't reveal any further details.
I'm not sure how that would work. Once a provider is on the NHS Drug Tariff, it's not as though there is a contract between the NHS and them to always supply, only that they will supply at x cost, indeed, as we know, the CCGs are at liberty to do what they want as part of their own procurement process. As the manufacturers are operating in a commercial environment in this case, if a procurement process excludes them, whether it's the NHS or somebody private, they're not really in a position to demand compensation. Especially as what has happened is new entrants to the market at lower prices causing disruption.Since it is likely that there may be legal fights for compensation by some of the excluded manufacturers,
As you say, the price info is in the BNF which is open access, so it is the selection process and criteria that could be disputed. Anyway, the report is not marked as commercial-in-confidence.I'm not sure how that would work. Once a provider is on the NHS Drug Tariff, it's not as though there is a contract between the NHS and them to always supply, only that they will supply at x cost, indeed, as we know, the CCGs are at liberty to do what they want as part of their own procurement process. As the manufacturers are operating in a commercial environment in this case, if a procurement process excludes them, whether it's the NHS or somebody private, they're not really in a position to demand compensation. Especially as what has happened is new entrants to the market at lower prices causing disruption.
why should you apply this? They all use whole blood for testing but they should all now report the results with plasma calibration, It was relevant some years ago, when there was still a mix in the UK with some meters reporting whole blood values and others plasma. This is what I wrote in my blog at the timeYes I will have to apply a correction of -12% to each reading, but I note that the guidance ranges given out on this site and others like DVLA seem to still be the whole blood values. But no one has confirmed this either way, so we are currently totally in the mire if we are hypo unaware
So the hypo level declared by @daisy1 at 3.9 mmol.l perhaps should read 4.368 mmol/l (or rounded up to 4.4 to match the meter resolution). Since new meters are coming out as plasma equivalent, then maybe this needs resolving soon
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